I have a 10 month old (10 months, 1 1/2 weeks) and he is starting to refuse the breast more often. Last Saturday night he woke up vomitting every 5-20 minutes for about three hours. Definitely had a stomach bug. My concern is that since then, his appetite has not returned and yesterday the only way I could get him to eat was to offer him a bottle. He will still nurse, but then refuses after only a couple minutes. I work (off on spring break) so he usually takes 3 oz bottles every 2-3 hours while I'm away. I don't want to stop nursing, but my son is a peanut and I am more concerned that he eats something. Prior to the stomach bug, he was eating three solid meals and nursing 8-12 times when I was home with him all day. Now he is only eating a small amount at breakfast, lunch and dinner, and the last three days he's refused to nurse from after his first nap until bedtime. He'll still nurse in the am and before bed, but not as long (and not as many gulps) as before. I'm so worried he is not getting enough- his wet diapers have decreased too. My concern is that if I stop nursing, he does't take more than the 3 oz bottle and therefore, he is not getting the "recommended" minimum amout of milk (24 oz). He is in the 1st percentile and I have been worried about his eating and low milk intake since he was 6 months old. Doctor says just keep trying, but I am feeling defeated. I want to do what's best for him and I use to think that was continuing to breastfeed, but lately I don't know. Is he weaning? If so, how do I transition him to whole milk (doc said this was ok at 11 months) when he drinks so little as it is? Do I keep perservering with nursing? I wanted to make it to a year at least, but don't know how much longer I can take this constant worrying. Any tips or suggestions? I feel at a loss and need advice from more experienced moms as I feel like I don't know what I am doing.

March 28th, 2013, 03:09 PM

@llli*davidsmomma

Re: is this the end?

So one more question: is it normal for older babies to start dropping feedings? Again today, he didn't want to nurse before lunch (solids) but would take a bottle. I'm wondering if I should just plan on giving him a bottle with lunch (to ensure he still has the milk) but then pump instead and nurse the rest of the day like normal. I know I probably stress too much about this, but I worry so much about him. If he wasn't such a peanut... at his 9 month check he was only 15 lbs. 7 oz. I wish this wasn't so hard and complicated.

March 28th, 2013, 05:28 PM

@llli*igrowpeople

Re: is this the end?

Quote:

Originally Posted by @llli*davidsmomma

So one more question: is it normal for older babies to start dropping feedings? Again today, he didn't want to nurse before lunch (solids) but would take a bottle. I'm wondering if I should just plan on giving him a bottle with lunch (to ensure he still has the milk) but then pump instead and nurse the rest of the day like normal. I know I probably stress too much about this, but I worry so much about him. If he wasn't such a peanut... at his 9 month check he was only 15 lbs. 7 oz. I wish this wasn't so hard and complicated.

First off, I wanted to offer you a :hug I honestly can't answer the first part of your OP because I have no experience with babies that struggle with putting on weight. I would say that in general to any parent, if there's a drastic decrease in his wet diapers, to get ahold of a pediatrician.

As for the bolded, it happens quite often in older babies when they learn new things (crawling/eating solids/walking) because they get so caught up in the new adventure of it. My son went from nursing 8-12 times during the day to 2-3 times between 10 and 13 months. Then suddenly he was back to breastfeeding anywhere from 5-8 times during the day.

March 28th, 2013, 07:26 PM

@llli*maddieb

Re: is this the end?

I agree with pp this could be temporary and not a problem. On the other hand, if there is some other reason for baby nursing less, it may keep going along this path and before you know it baby is weaned prior to when you want and prior to what is most healthy. So you might want to investigate.

If this is only happening at a certain feeding(s), it may help to look at what (if anything) makes that feeding different. More distractions? Different position? Mom feeling rushed? Sometimes what is bugging baby takes some detective work!

At this age a baby actually refusing to nurse at all usually indicates a nursing strike. Usually these occur pretty suddenly, however, it is something to consider if this is the beginning of one. Also it is theorized that some babies fall victim to what is known as "triple nipple syndrome" -if they have bottles and/or pacifiers, over time, they stop seeing the breast as THE place for both food and comfort and look elsewhere. It is thought that this kind of thing may also happen if a baby is being ‘overly encouraged’ to eat solid foods, drink more water than needed (or juice at all) from a sippy, or otherwise encouraged to regularly fill up on something besides breastmilk at the breast.

Have you had any issues with adequate milk production? A slow down in the milk flow from the breast may add to breast refusal issues...

No matter what the cause, the remedy is the same-gently encouraging baby to nurse as much as baby will.

If it is not already being done, you can also have your caregiver give bottles in a breastfeeding supportive way, which would include feeding baby on cue so if baby only takes small amounts in bottles at a time, but will eat more frequently, may result in more milk in baby. For that , see http://www.llli.org/docs/00000000000...astfedbaby.pdf

If low production/slow flow is part of the issue, doing something about that (galactagogues, extra pumping, breast compressions, etc.) may help as well.

ounce for ounce, breastmilk has more calories, healthy fats, and nutrition than “solid” food. So from a growth standpoint, breastmilk is still “best," so your plan to make sure baby gets more is a good one, except that ‘extra’ bottles it may end up leading to less interest in the breast. So??? I cannot tell you what is best. It’s just something to think about. Your baby being in the first percentile is not in and of itself an issue, if growth overall has been consistent. If it has not, that is a different story.

March 30th, 2013, 03:34 PM

@llli*davidsmomma

Re: is this the end?

Thanks for the info & suggestions. I'm just feeling really defeated at this point and while I really want to keep nursing, I don't think I can emotionally withstand this constant battle. These last few days he continues to resist the afternoon feedings and it's just too hard for me too keep fighting: I mean like full out screaming, arching his back and pushing away from me, but he'll take a bottle. I'm so sad but I also don't want to feel so upset with him and I want him to eat. Any suggestions on how to transition him to whole milk (slowly- doc said ok to be on all whole milk at 11 months- he's ten and a half months). I plan to keep pumping as much as I can and I do have a large supply of frozen, but I have already had difficulties pumping enough and I know eventually my frozen supply will be depleted. I'd like to start the transition (just for the afternoon Feedings for now) so he takes the whole milk before my frozen is gone (like I said I want t I traduced it slowly). I also plan to keep nursing in the morning and night as long as he will take it and my supply holds up. PLEASE give advice- I'm overwhelmed and at a loss. I didn't plan to start weaning this early, but i'm emotionally exhausted and think it's time. Thank you.

March 30th, 2013, 06:51 PM

@llli*maddieb

Re: is this the end?

I guess I am wondering what you mean by "afternoon feeding." Is baby on sceduled feeding sessions rather than cue fed?

I also wonder if part of the problem is that you think your baby "should" be nursing for a certain length of time. If baby just wants to nurse for a few minutes, that is pretty common with older babies and when baby gets busy. I get it you are concerend about weight, so...What if, instead of a bottle, you just offered to nurse again in a short time?

If your job and pumping at work is causing undue stress, maybe it's time to consider alternatives to what you are doing...maybe bottles of formula (?) during the day so you don't need to stress so much about how much milk you have to pump, a different work scedule, more down time to relax with baby on your days off, getting more help at home for evenings and other times with baby, etc.

Weaning starts when a baby starts taking anything other than breastmilk. So weaning started some time ago! Maybe what is happening now is part of the weaning process for your baby, maybe not.

If you want to keep nursing, keep nursing, as much as you and baby like. In the normal course of things, the frequency of nursing at the breast slowly goes down, a bit at a time, to be replaced by solid foods. That is how weaning works. It is naturally quite gradula, but it goes faster for some kids than others.

I still suggest that totally eliminating nursing sessions this early, especially if they need to be replaced by bottles of anything, is very possibly not true weaning but some other issue. However, it is what it is. if baby will not nurse and you cannot find a way to gently encourage more nursing, weaning from the breast will happen, perhaps faster than you originally intended, and that is absolutely ok, as long as baby's nutritional and emotional needs are being met. Sometimes baby will drop to just 3 or 4 or even one or two feedings a day but keep those few feedings for a long time...it's hard to say. the weaning process is very individual.

Unfortunately I cannot talk about transitioning from breastmilk to whole milk verses to formula. It's just outside my knowledge.

March 30th, 2013, 09:15 PM

@llli*davidsmomma

Re: is this the end?

Thank you lllmeg. I have some more questions in response to your post:

Quote:

Originally Posted by @llli*lllmeg

I guess I am wondering what you mean by "afternoon feeding." Is baby on sceduled feeding sessions rather than cue fed?

I try to cue feed- however, it's becoming more scheduled because of my work schedule and trying to nurse before solid meals. What I meant by afternoon feeding was the nursing session prior to his lunch. I used to feed more on demand, but it's becoming more difficult because my son doesn't really ask to nurse- in fact, I'm pretty sure he'd go hours or even most of the day without asking to nurse if I didn't offer. Because of the weight concerns, I offer frequently. I wonder if this is a problem for him? I am just afraid if I don't offer, he won't eat and thus add to the weight concerns.

I also wonder if part of the problem is that you think your baby "should" be nursing for a certain length of time. If baby just wants to nurse for a few minutes, that is pretty common with older babies and when baby gets busy. I get it you are concerend about weight, so...What if, instead of a bottle, you just offered to nurse again in a short time?

I do offer all the time. Could I be upsetting him by offering too much? Why would he take a bottle but not nurse?

If your job and pumping at work is causing undue stress, maybe it's time to consider alternatives to what you are doing...maybe bottles of formula (?) during the day so you don't need to stress so much about how much milk you have to pump, a different work scedule, more down time to relax with baby on your days off, getting more help at home for evenings and other times with baby, etc.

Weaning starts when a baby starts taking anything other than breastmilk. So weaning started some time ago! Maybe what is happening now is part of the weaning process for your baby, maybe not.

If you want to keep nursing, keep nursing, as much as you and baby like. In the normal course of things, the frequency of nursing at the breast slowly goes down, a bit at a time, to be replaced by solid foods. That is how weaning works. It is naturally quite gradula, but it goes faster for some kids than others.

I still suggest that totally eliminating nursing sessions this early, especially if they need to be replaced by bottles of anything, is very possibly not true weaning but some other issue. However, it is what it is. if baby will not nurse and you cannot find a way to gently encourage more nursing, weaning from the breast will happen, perhaps faster than you originally intended, and that is absolutely ok, as long as baby's nutritional and emotional needs are being met. Sometimes baby will drop to just 3 or 4 or even one or two feedings a day but keep those few feedings for a long time...it's hard to say. the weaning process is very individual.

Can I maintain a supply if I am only feeding in the mornings and later afternoons/ evenings (and not midday when he rejects the breast the most)? Do I give him a bottle then with lunch or will this encourage weaning further?

Unfortunately I cannot talk about transitioning from breastmilk to whole milk verses to formula. It's just outside my knowledge.

March 31st, 2013, 05:28 AM

@llli*mommal

Re: is this the end?

Babies often take a bottle instead of nursing because bottles are easy. A bottle will generate milk flow even with the sloppiest latch and laziest suckling. And unless you are cradling the baby while feeding him by bottle, the bottle is something baby can take with him as he wanders around the house, playing. In his mind, that's a huge time-saver. He can eat AND play!

If you nurse just in the morning and at night, you will maintain a small milk supply. I nurse my 3 year old just once or twice a day and still have milk- but it's a really small amount. I rarely hear her swallow, though she usually has milk in her mouth after I nurse. She gets maybe a few teaspoons of milk. If you can pump during the day or at night, you'll maintain a better overall supply.

March 31st, 2013, 09:48 AM

@llli*maddieb

Re: is this the end?

I think it is fine to offer to nurse as long as you're not pressuring baby to nurse. When a baby becomes very busy and is not nursing with a normal or needed frequency then it really does become necessary to at least offer, suggest or in someway find every opportunity in which to nurse. But if baby nurses and it's five minutes let it be five minutes if he wants more he should request to nurse more. Does that make sense? As mommal says a bottle can be carried around or is very quick or knows why he takes a bottle as opposed to nursing. But assuming you have milk in your breasts there is no reason for him to take a bottle as opposed to nursing. Let him nurse a short time and then if he wants to nurse again 10 minutes or 15 minutes or one hour later fine.
Scheduling is a problem because then sometimes mom becomes too concerned if baby does not nurse at a specific time or for a specific length of time. You also may miss the more subtle cues because you think that 'he couldn't possibly want to nurse now' this is true when baby is an infant and when baby is a toddler. Yes of course we all do fall into more regular feeding patterns but generally it is best to resist it becoming a schedule if you know what I mean.

When it is suggested that mothers nurse before solids that is general advice. it is meant to prevent baby being filled up on solids instead of breast milk and consequently leading to earlier weaning. if that suggest is not working for you or not working at a particular time it's time to try something different. I have started introducing solids to my eight month old and I don't think I ever consciously nurse before offering solids which I do about two or three times a day at our family meals. however she always wants to nurse afterwords because she's thirsty and probably hungry because she is not able to get much of anything into her mouth. she also nurses lots of other times of the day and night so in my case it simply is not necessary to nurse her before solids. perhaps in your case something similar would work let baby have solids and then offer to nurse assuming you're home.

Baby should also be cue fed, not scheduled, when you are at work. that is what the paced bottlefeeding link I put above is about in part.

March 31st, 2013, 09:54 AM

@llli*maddieb

Re: is this the end?

As far as maintaining milk production on just a couple of feeding sessions a day , again this is very individual. Yes as mommal says many babies and in particular toddlers and older children will continue to nurse for very long time only a couple of times a day. But in many such cases these are children who really like to comfort at the breast and will nurse even if there is not much milk. However some babies require a certain rate of flow or they simply will lose interest in the breast in entirely. those babies may tend to not nurse for long once production has decreased a great deal.